Lisa Maria Russo, RD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

952153 Issued in NJ

Practice address

216 Palmer St
Elizabeth, NJ 07202-5900

Phone

(908) 353-0500

NPI assigned

Jan 26, 2007

Last updated

Jan 31, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Ms. Lisa Maria Baptista Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nbimc Trinitas Pediatric Medical Group

  • Pediatrics Physician
  • Elizabeth, NJ
  • NPI 1144288366
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1831245687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CHURCH TOWERS",
            "address_2": "APT 2N",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "07030",
            "telephone_number": "973-460-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 PALMER ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072025900",
            "telephone_number": "908-353-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NJ",
            "license": "952153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE CROSS",
            "identifier": "223452311",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "223452311",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "3980567",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNCIL OF AFFORDABLE QUA",
            "identifier": "11452348",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0251854103",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3595969",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BAPTISTA",
            "middle_name": "MARIA",
            "prefix": "MS.",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Russell Rudyk
• Donna Lynn Ruh, CRNA
• Hermes Jesus Ruiz, DC
• Ruth Ruiz
• Kathleen E. Russo, LCSW
• Saadiya Health LLC (Elizabeth Pharmacy)
• Elvira Sabater, DDS
• Natalya Saburova, MD
• Zain Sadiq
• Hasham Saeed, MD

• Pediatric Nutrition Registered Dietitian in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Pediatric Nutrition Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.